BackgroundUncontrolled high blood pressure (BP) or hypertension is the leading cause of death in Australia. However, only one-third of Australians with hypertension achieve optimal BP control. The key barrier is treatment inertia - hesitancy of health-care providers to initiate or intensify treatment after high BP readings. This is frequently driven by uncertainty around “true” BP due to problematic assessment of office BP readings, high variability of BP and a low number of BP measurements taken in primary care to guide decision-making.High blood pressure is a major risk factor for stroke, cardiovascular disease and chronic kidney disease and presents a considerable health burden. One in three Australians suffer from high blood pressure and only 32% have effectively controlled blood pressure.If all Australians currently living with high blood pressure were properly treated, as many as 83,000 lives could be saved resulting in a $91.6 billion return. However, GPs are hesitant to start or intensify blood pr

This project is a co-produced study of the experiences of people with chronic kidney disease and multiple other long-term conditions when navigating the health and care system. It stems from a series of discussions among a group of patients, brought together through kidney patient networks, and academic researchers, to identify their priorities in patient-driven kidney research. Through their own lived experience, the group members recognised the significant challenges that patients face when navigating the intricacies of the health and social care system to receive appropriate holistic care. This can, in turn, negatively influence their wellbeing and quality of life. The group concluded that this was a priority theme for research, with this project seeking to identify opportunities for improvement, through patient education and empowerment, or systems changes.   Aim: The project has four core objectives: To collect, review and understand the experiences of people living with chronic

Background Multimorbidity, defined as the coexistence of two or more chronic conditions, including mental health conditions and infectious diseases of long duration, is an emerging problem with a rising trend in low- and middle-income countries (LMIC). With the rapid epidemiological transition occurring in India, multimorbidity has become a significant challenge. However, there is a lack of reliable estimates regarding the patterns of multimorbidity. Without identifying patients at an increased risk of developing specific combinations result in worse outcomes, it is difficult to plan programs or allocate resources for managing multimorbidity effectively. Therefore, it is essential to generate reliable information on multimorbidity profiles. The study will focus on reviewing analytical methods and available data sources. In India, it is crucial to understand the process of producing reliable evidence and ensure appropriate benchmarking and validation of multimorbidity profiles for the population. Furt

Background Worldwide the leading risk factor for death is raised blood pressure  (BP), accounting for ~30,000 deaths daily.1 In Australia, high BP is responsible for 43% of coronary heart disease, 41% of stroke, 65% of the burden of hypertensive heart disease, 38% of chronic kidney disease, 32% of atrial fibrillation and flutter and 3.6% of dementia.2 Better BP control could save more lives than any other single treatment intervention.3 In Australia, BP control rates have stagnated since 2011 at ~32%,4, 5 leading to a 2022 call to action to improve uncontrolled BP in Australia.5 Hypertension (the condition you have from high BP) is called the "silent killer" because most people who have raised BP do not have any symptoms.6 In Australia, 34% of adults have hypertension,4 but millions remain unaware and undiagnosed.6, 7 Only one in two people detected to have high BP are aware of their condition.8 Innovative strategies to target wider and high-risk populations,

Nigeria has a history of poor maternal healthcare. Nigerian women are 500 times more likely to lose their lives during childbirth compared to women from high-income countries (HIC). In 2020, Nigeria had the highest number of maternal deaths (82,000) in the world and accounted for more than a quarter (28.5%) of global maternal deaths. This translates to about 145 maternal deaths every day. Low quality of care is a major driver of poor maternal health outcomes in Nigeria. Quality of care has two components: provision of care and experience of care. However, efforts aimed at improving maternity care in Nigeria often focus on the ‘provision’ aspect of care alone. While it is important to invest in the supply aspect of care, it is also imperative that women’s experiences of care are given equal attention.   Aims This study aims to map women’s pregnancy journey to examine their experiences in accessing care and investigate their ideas of satisfactory quality of mate

Background Acute Kidney Injury (AKI) affects up to 1 in 2 patients treated in the ICU, and is associated with poorer survival, reductions in long term kidney function and greater cost of treatment. There are no treatments proven to reduce these impacts of AKI but there is a growing evidence base suggesting that inhibitors of the sodium-glucose transport protein 2 (SGLT-2 inhibitors) in the kidney tubule may protect against AKI. SGLT-2 inhibitors were originally developed as a treatment for type 2 diabetes but have been proven in recent clinical trials to significantly improve outcomes for patients with heart disease and/or kidney impairment - with fewer patients progressing to dialysis, needing hospital care or dying. Later examination of these trials has also shown lower rates of AKI in participants receiving SGLT-2 treatment but, as these results were not the main outcome of the studies, these findings are not enough to change patient treatment. Aim To conduct a prospective, multi-centre, parall

BackgroundThe countries of Brazil, India and South Africa have mixed health systems wherein public and private providers operate side-by-side to deliver the same set of services. The health administrations in these countries are increasingly purchasing services from the private sector for delivering care. There is some evidence to suggest that the purchase arrangements could contribute to quick expansion of health access. But at the same time, community participation rooted in the human rights framework hitherto has largely been envisaged as part of the public health system for better responsiveness and accountabilities. But the changing scenario, of the governments actively engaging private providers (both private for-profit and private non-profit), is making health systems pluralistic. In such a pluralistic scenario does the conventional understanding of Community participation hold and whether community participation can still aim for better health system effectiveness?AimTo strengthen the participation an

Background Access to essential medicines is a critical building block of the health system, but many low-and middle-income countries (LMICs) continue to face major challenges in ensuring medicine accessibility, affordability and quality. The sale of medicines online (or e-pharmacy, we use the terms interchangeably)  represents a major disruption to pharmacy provision across the globe. Whilst e-pharmacy was initially the preserve of high-income countries (HICs), in the past decade it has been growing rapidly in LMICs, and this growth was further catalysed by widespread lockdowns during the COVID-19 pandemic. This rapid expansion of e-pharmacy has been largely uncontrolled and accompanied by significant public health concerns, the most commonly cited being the sale of prescription-only medicines (POMs) without a prescription, including opioids and antibiotics; the sale of substandard or falsified (counterfeit) medicines; inadequate provision of information to patients; and erosion of the doctor-pharm